UB physicians discuss COVID-19 lessons learned

When vaccine researcher John R. Mascola outlined the COVID-19 story — from the pandemic’s first appearance to the authorization and use of vaccines — at the UB Clinical and Translational Science Institute’s (CTSI) Annual Forum on March 17, among the most engaged audience members were several of the university’s notable and frequently quoted infectious diseases experts.

While these researchers have been studying the coronavirus for the last year-plus, they welcomed the opportunity to hear from Mascola, a co-author on many of the publications on the Moderna mRNA vaccine and director of the Dale and Betty Bumpers Vaccine Research Center (VRC), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH).

They also embraced the chance to join Mascola for a post-presentation conversation. The UB researchers who participated were:

• Alan J. Lesse, associate professor and vice chair for education and senior associate dean for medical curriculum, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences.
• Timothy F. Murphy, SUNY Distinguished Professor, Department of Medicine; senior associate dean for clinical and translational research, Jacobs School; director, Clinical and Translational Science Institute; and director, Community Health Equity Research Institute.
• Thomas A. Russo, professor and chief of the Division of Infectious Diseases, Department of Medicine.
• John A. Sellick Jr., professor, Department of Medicine; section chief, Infectious Diseases, Veterans Affairs Western New York Healthcare System; and a hospital epidemiologist, Kaleida Health.

Now, a little more than a month after the forum and that conversation with Mascola, UB’s Lesse, Murphy, Russo, and Sellick are reflecting on lessons learned from COVID-19. More of their thoughts are available in a feature on the CTSI website.

Russo: “I think the first lesson was that our public health system had been significantly eroded. We were in between pandemics or health care crises, and those funds were diverted elsewhere. When the pandemic came along we were ill prepared to handle it. In the United States, there is both a central component and a statewide component to public health; those entities were in different degrees of disarray. This pandemic will end, but we have to remember that we cannot divert resources for public health because there will be another pandemic. I guarantee it.”

Murphy: “COVID-19 has placed a spotlight on the health inequities in our entire system of health care. People who are underserved, and racial and ethnic minorities have suffered the most from this pandemic. In addition, with regard to communication, we have to use multiple different approaches in order to reach many different audiences. If we are talking specifically about vaccine hesitancy, what are the reasons? There are so many explanations for why people are hesitant, and there are ways to approach each one.”

Sellick: “States were fighting against and outbidding one another to get equipment and supplies. That does not work. There needs to be a much different system. The federal government cannot determine what goes on at every town in the United States, but they can at least get everybody on the same page and say, ‘Here is where we are getting the supply. Here is what we expect you to do. Here is the data we are going to gather. Here is what we are going to do with the data.’ It took us more than a year to get to that point.”

Lesse: “In addition to national standards for treatment, we need to make sure that we have a well-funded system for analysis and data-gathering. In the past, it has been the CDC. During this pandemic with massive death totals, we were not relying on the CDC — we were relying on Johns Hopkins University and the COVID-19 Project because there was nobody else organizing the information that we needed in real time. We were massively behind the rest of the world in sequencing of viral strains for variants. [Now], we have caught up.”

Russo: “Another lesson relates to vaccines. Infectious disease and public health officials know that vaccines are the number one medical advancement in terms of preventing life loss and significant morbidity and mortality. We have struggled to achieve a high level of vaccine acceptance over the past 20 years, due to the fact that we have eradicated or significantly controlled so many of these infectious diseases. Because of the success of the vaccines, the public no longer appreciated the severity of these infections. Further, the rise of the ‘anti-vaxxer’ movement that is based on misinformation fueled mistrust. We are now blessed with multiple vaccines directed against SARS-CoV-2, and we have now gotten hundreds of millions of doses into the arms of individuals.

“What I am hoping for is that the people of this country and of the world see that vaccines are an extraordinarily positive thing in medicine. I hope that people will appreciate how vaccines saved us from this pandemic and will more broadly embrace their use moving forward.”